Тематичний Архів | Category Archives: Population cardiology

M.M. Mursalov Features of arterial hypertension in the male population of internally displaced persons aged 20–59 years living in the city of Sumgait

The aim – to study the peculiarities of arterial hypertension (AH) among internally displaced persons males aged 20–59 years living in the city of Sumgait.

Material and methods. We studied males in the age of 20–59 years living in Sumgait and being internally displaced persons. We randomly selected groups of 500 persons each in age groups: 20–29, 30–39, 40–49 и 50–59 years. The final sample included 71,8 % patients that underwent complete study protocol.

Results. Amonth the surveyed subjects without AH the level of blood pressure was 118.7±0.5/75.8±0.3 mm Hg. The prevalence of AH increased along with age, from minimal level at 20–29 years (7.4±1.7 %), to maximal at 50–59 years (67.8±3.3 %; Р<0.001). The highest increase of the prevalence was found in the range from 40–49 to 50–59 years – more than 2 times (accordingly, 33.8±3.3 and 67.8±3.3 %; Р<0.001). Conclusions. It has been found that the presence of AH was observed in 31.8±1.6 % of surveyed individuals, including 15,8 % with isolated systolic hypertension. Optimal level of blood pressure was registered in 29.5 % patients, normal – in 12,0 %, high normal blood pressure – in 2.0 %. In the structure of AH most commonly there was observed AH stage I – 85.22 %, followed by AH stage II – 10.5 % and 4.73 % were AH III degree. Among patients with AH only 34.18 % received treatment, in only 3.6 % the treatment was effective.

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I.V. Drozdova, A.A. Babets, L.G. Stepanova, L.V. Omelnytska Morbidity, prevalence and disability related to essential hypertension: approach to the analysis and prediction

The aim – to develop approaches to assessing and predicting prevalence, morbidity and disability due to the essential hypertension (ЕH) to characterize public health.

Material and methods. Analysis of the incidence and prevalence of ЕH, as well as primary disability is provided given according to the available data from state research institutions. Short-term prediction analysis and prediction of morbidity and disability were conducted using adaptive methods.

Results. During 2014–2015 years among adult population of Ukraine incidence of ЕH decreased by 2.80 %, disability – by 33.3 %, while prevalence by 0,8 %. Among working age population incidence of ЕH was reduced by 1.83 %, primary disability – by 33.3 %, prevalence increased by 3.2 %. Adaptive methods of short-term prediction point to increased incidence, prevalence and disability related to the ЕH in different regions of Ukraine.

Conclusions. During health care reform in Ukraine there is a need to develop new monitoring systems evaluating morbidity and disability as indicators of public health.

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O.O. Kvasha, I.P. Smirnova, I.M. Gorbas, O.V. Sribna. Cardiovascular risk profile of the urban men: 35-year dynamics

The aim – to evaluate long-term dynamics of the epidemiological conditions of CVD formation among urban men.

Material and methods. During 2014–2015 there were examined 855 men aged 18–64 years. The findings were compared with results of the similar design studies, performed in 1980 (n=1258), 2000 (n=1025), 2005 (n=998) and 2010 (n=1009).

Results. There were no sustained changes of the prevalence of arterial hypertension (30,6 and 27,6 %); prevalence of increased BMI decreased from 44,8 to 33.8 % (Р<0.01), smoking – from 49.9 to 35.2 % (Р<0.01). At the same time, a pronounced and significant increase of risk factors, such as low physical activity (from 19.7 to 38.6 %, Р<0.001), obesity (from 11.3 to 19.7 %, Р<0.01) and hypercholesterolemia (from 46.7 to 60.3 %, Р<0.01) was noted. The percentage of the surveyed subjects with one risk factor decreased by 2.6 times, while the proportion of men with combination of 3 or more risk factors increased by almost 5 times. Conclusions. The negative dynamics of the risk profile among urban men leads to the increase of the population cohort with high risk of CVD and, thus, to the deterioration of health indicators. It is necessary to develop and permanently implement active prevention measures in order to improve epidemiological conditions of CVD formation in the population.

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V.M. Kornatsky, A.P. Dorogoi, Zh.H. Adaricheva. Clinical pharmacoeconomic analysis in the cardiology practice

The aim – to study features of drug prescriptions for the treatment of arterial hypertension (AH) in outpatient and inpatient settings using integrated AVS-, VEN (Vital, Essential, Non-essential) and frequency analysis.

Materials and methods. Physician recommendations in outpatient cards and in discharge notes after hospital treatment were retrospectively analyzed using peer review method according to the designed protocol. The study included 213 records of patients (101 males) with AH stage I and II who had blood pressure of 140/90 mm Hg and above. Patients with stage III AH, concomitant tumors or any other serious diseases requiring pathogenetic treatment were not included in the study. VEN-analysis was performed to study compliance with clinical protocols or guidelines. Classes of recommendations, level of evidence, results of randomized clinical trials and relevant meta-analyses were taken into account. If a drug recommended by doctor was based on guidelines, it attributed to the category of «V» – vital: diuretics (thiazide or loop), angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers and β-blockers.

Results. Every patient with AH in general clinical practice is recommended to take up to 4 drugs (4.3 for women, 3.6 for men). Original and generic foreign drugs are prescribed more often even in the presence of Ukrainian analogues in the pharmaceutical market. The fixed combinations of antihypertensives are prescribed less than the same drugs separately, affecting adherence and cost of treatment.

Conclusions. Polypragmasy is noted in the outpatient treatment of patients with AH; drugs of foreign manufacturers, insufficient use of fixed drug combinations dominate in prescriptions that adversely affects both adherence and cost of treatment.

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О.O. Kvasha, I.P. Smirnova, I.M. Gorbas, O.V. Sribna Dynamics in the structure of lipid factor of cardiovascular risk at 35 years follow-up among urban male population

The aim – to estimate the prevalence of hypercholesterolemia (HCh) and its dynamics according to the 35-years monitoring of the urban males risk profile.

Material and methods. In 2014–2015 years we examined 855 men aged 18–64 years. The obtained data were compared with results of similar design studies carried out in 1980 (n=1258), 2000 (n=1025), 2005 (n=998) and 2010 (n=1009).

Results. There were no changes in age-standardized prevalence rates of hypo-α-cholesterolemia (15.5–15.3 %). At the same time we’ve found a significant increase in HCh from 46.7 to 60.3 % (Р<0.01) and high and very high levels of cholesterol LDL – from 24.3 to 58.2 % (Р<0.001). The increase of average population cholesterol values ​​(from 5.21 to 5.76 mmol/L, Р<0.001), LDL cholesterol (from 3.34 to 4.09 mmol/L, Р<0.001) and decrease of HDL cholesterol (from 1.36 to 1.08 mmol/L, Р<0.01) were registered. Conclusion. The negative dynamics of lipid profile among urban men appears to be caused by the deterioration of the economic and socio-political situation in the country. Further studies are needed to understand the persistence of identified changes and evaluate their possible contribution to the development of future population health data.

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Yе.P. Svyshchenko, L.A. Mishchenko, on behalf of the trial «Age of vessels» participants. New concept evaluation of cardiovascular risk by Framingham criteria – determination of the age of vessels. The first experience in Ukrainian population of patients with arterial hypertension

The aim – to presented the results of the trial of cardiovascular risk stratification in hypertensive patients using Framingham criteria of evaluation of the vessels age.

Material and methods. 987 patients with uncontrolled arterial hypertension were included in this epidemiologic multicenter study. Determination of the calculated vessels age was done based on estimation of blood pressure (BP) level, presence of diabetes mellitus, smoking status, blood levels of total cholesterol and high density lipoprotein cholesterol.

Results. Discrepancy between passport age of patient and age of vessels, calculated by the Framingham criteria, was detected in the Ukrainian population of patients with hypertension. This is due to the increase of blood pressure and high prevalence of risk factors, such as dyslipidemia (76 %), smoking (29.9 %) and diabetes mellitus (24 %). It was established that these risk factors exert a significant influence on younger people compared to the elderly. The presence of dyslipidemia in patients with hypertension increases calculated age of the vessels by 6 years, diabetes – by 5 years, compared to patients with normal lipid and carbohydrate metabolism. Smoking adds further 3 years, and increased blood pressure of 140/90–159/99 to 180/110 mmHg or greater increases the average age of the vessel by 8 years.

Conclusions. Our findings give evidence of unfavorable impact of cardiovascular risk factors (especially their combinations) upon premature aging of the vessels.

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O.I. Mitchenko M.N. Mamedov, T.V. Kolesnik, A.D. Deev, V.Yu. Romanov G.Y. Ilyushina. Features of cardiovascular risk factors in women depending on menopause

The aim – presents sub analysis of cardiovascular and cardiometabolic risk factors in a large population-based study conducted in Dnipropetrovsk female population (n=532, age 30–69 years) in 2009–2013, depending on menopause.

Material and methods. The analysis of the epidemiological characteristics of the cohort of female urban population of Dnepropetrovsk (n = 532) was performed, depending on menopause. The surveyed subjects were divided into two groups: I group consisted of 217 women of reproductive age (average age 39.7±0.4 years), II group – 315 postmenopausal women (average age 57.6±0.3 years).

Results. The study reported relatively lower, compared to the European data, average age of menopause in the urban population of Ukraine (48.9±0.3 years). This was accompanied by significant manifestations of cardiovascular risk factors. The onset of menopause was associated with high percentage of overweight and abdominal type obesity. Along with onset of the menopause, the prevalence of hypertension was increased by half compared to women of the reproductive age (from 30.2 to 68.1 %). Pro-atherogenic changes of lipid and carbohydrate metabolism were detected significantly more often. The prevalence of smoking declines at onset of the menopause from 18.6 to 7.6 %, but this risk factor is preserved in the older age groups.

Conclusion. The dramatic increase in the prevalence of risk factors may be associated with an earlier manifestation of cardiac disease on background of hypoestrogenemia.

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Ye.A. Kvasha Quality and quantity characteristics of alcohol consumption in male population and their dynamics: data from the epidemiological surveys.

The aim of the epidemiological survey was to study the structure of men alcohol consumption (frequency, volume, beverages) according and estimate the dynamics of these indicators for the 10-years period. Drinking
habits were established in the course of two cross-sectional epidemiological surveys of random samples of men aged 20–64 years in Kyiv performed 10 years apart. The number of investigated men in 2000 was 997, in 2010 – 1009. After 10 years the number of men consuming alcohol (ALC) during one year has generally decreased (from 93.2 to 84.2%, Р<0.001). The average amount of alcohol recalculated on pure ethanol significantly decreased from 19.54±0.98 to 17.60±0.10, P<0.05). The number of people consuming excessive amounts of ALC decreased from 36.9 to 31.9%. The revealed changes are characteristic for all age groups. In all age decades the increased percentage of people consuming ALC several times a week or daily increased (generally from 26.8 to 31.8%, P<0.05). Despite some positive changes of type of alcohol consumption it is still typical for men in Ukraine to consume large doses of strong alcohol from time to time, with increase of its role as a risk factor of total and cardiovascular mortality.

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Ye.A. Kvasha Influence of overweight upon cardiovascular mortality of women: the prospective study.

The aim of the study was to estimate contribution of body mass to mortality from cardiovascular and other chronic disease and to study dynamics of prevalence of this risk factor according to cross-sectional examinations of female representative samples in the age from 40 to 59 years. Relative risk of death associated with body mass was estimated on the basis of 20-years prospective study of female population 40–59 years old in Kyiv and level off attributed risk was used for assessment of contribution of body mass to cardiovascular mortality. The data of two population surveys carried out according to epidemiological programs were presented. The study indicated that the attributive risk of stroke for death was determined by obesity in 67.7% and ischemic heart disease – in 28.0%. During last 30 years the prevalence of overweight in female population has decreased by 9.9%, however combination of overweight with other risk factors has considerably increased.

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A.V. Іpatov, Yu.I. Коrobkin, I.V. Drozdova, I.Yu. Khaniukova, М.G. Sydorova Diseases of cardiovascular system: leading tendencies of the dynamics of disability.

The analysis of dynamics of disability of adults and working age population of Ukraine resulting from cardiovascular diseases in 2000–2010 was conducted based on the official statistical data. Information technology of estimation of dynamics of disability in Ukraine was elaborated. One of its constituents was an analysis of sentinel rows, based on regressive approach. This technology gives opportunity to describe the dynamics of disability as a result of cardiovascular diseases in different regions of Ukraine, to distinguish leading tendencies of this process, to set the relative risk of disability increase, to establish regions with the increase of primary disability and expect the level of the “hidden” disability, to forecast future tendencies making possible to improve monitoring of disability in Ukraine in future. The received data regarding dynamics of disability as a result of cardiovascular diseases testify to the insufficient or incomplete use of possibilities of medico-social help in Ukraine. The considerable expected prospects are in relation to the improvement of quality of work of all medico-social examination service at further introduction of contemporary medical information technologies.

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